| Doctor Name: | KAREN JELLERSON |
| NPI Number: | 1114317534 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | SW11868 |
| Business Practice Address: | 3433 Desoto Dr Punta Gorda, FL - 339833525 |
| Business Phone Number: | 9412491629 |
| Business Fax Number: | |
| Mailing Address: | 3433 Desoto Dr, PUNTA GORDA |
| State: | FL |
| Postal Code: | 339833525 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 01/24/2015 |
| NPI Last Update Date: | 01/24/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | SW11868 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |